| The basic character of carcinoma is invasion and metastasis, there are so many factors, mechanisms and stages involving this complex process. In order to find some special biologic changes of carcinoma and translate these results of study to doctors in diagnosis, treatment and evaluation the prognosis of carcinoma in their clinical works, we need to do some research on invasion and metastasis of carcinoma.The epiglottis squamous cell carcinoma is a common supraglottal laryngic carcinoma . Because of which site and local anatomy character, it can be invasive growth and easy metastasis to lymph nodes, quick exacerbation, easy to metastasis to the other sites and poor prognosis, till now, we have not found the mechanisms. In my study, u-sing the samples of epiglottis squamous cell carcinoma, through analysis the pathologic factor of invation and neck lymph node metastasis (including carcinoma itself and body factors) , detecting the express of cyclinD1 and CD20 on epiglottis squamous cell carcinoma using im-munohistochemical technique , we want to find some mechanisms of invasion and metastasis of epiglottis squamous cell carcinoma, to evaluate the state of diagnosis and prognosis of this disease and help thedoctors treat their cancer patients.MATERIALS34 cases of the epiglottis scpiamous cell carcinoma were included in the study and had surgery, there were 19 males and 15 females in the study, their age was 40 - 83 years old, the time of having symptom to seeing doctor was one month to two years, there were 10 patients having lymph node metastasis ( proved by pathology). All the patients did not get radiation therapy and chemotherapy before surgery and diagnosis of squamous cell carcinoma was proved by pathology after surgery.METHODSThe carcinoma itself in sample was cut into 5um paraffine slices by routine and the controls were the normal tissue around the carcinoma , then some for H - E stainning, observed by optics microscope , the others for immunohistochemical stainning.1. Pathologic histology and TNM : see UICC 1987 of PTNM classification.2. Mode of Invation(MI) : see Jacobssons type, it includes four types.3. Peritumoral Lymphocytic Infiltrating Density (PLID): using LUZEX - F image analysis, we count the numbers of lymphocytes under optics microscope 400 times. Each sample was observed three visual fields and took the median, according to the data, samples were divided into high, middle or low three groups.4. Immunohistochemical stainning: using biotin -ABC - immunohistochemical technique, we detected the express of cyclinD1 andCD20 on epiglottis squamous cell carcinoma, negative control used PBS replace the first antibody. Result: cyclinDl positive is brown granule seen in cytoplasm; CD20 positive is B lymphocyte brown dyed in interstitial. Negative is no color dyed.5. Statistics: All statistical analyses were performed using SPSS/ PC. In all analyses,P <0.05 was taken as significant.RESULTSAmong all factors about epiglottis squamous cell carcinoma metastasis to neck lymph node in monovariate analysis, T stage, G stage, Mode of invasion, PLID, cyclinDl protein and CD20 were all correlated with epiglottis squamous cell carcinoma metastasis to neck lymph node, P<0.05; 3,4 type invasion, low PLID and overexpres-sion of cyclinD1 indicated patients failed to inhibit carcinoma invasion, then the chance of neck lymph node metastasis was increased.Among multivariate analysis about mode of invation, T stage and PLID were positive factors, P =0. 013 and P =0. 026 respectively. It suggested that high PLID might inhibit carcinoma invasion and lymph node metastasis.DISCUSSIONFor a long period, the TNM is the major reference for the clinical doctors in choosing the treatment scheme and the evaluation of the prognosis before treating the carcinoma of the head and neck. But for the different part of carcinoma and the mode of invasion and the reaction of the body to the carcinoma, the healing effect may not coherent to the TNM in most cases. However, there still a lo...
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